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19 December 2009
This article is part of the series Swine Flu.
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How Dutch Minister Klink decided on vaccines with additives - 1

By Daan de Wit
Translated by Ben Kearney

In the international battle against Swine Flu different countries use different vaccines to protect their citizens. In the Netherlands vaccines containing additives are
being used. Even women 13 weeks pregnant are receiving this vaccine. In arriving at his decision, Dutch Health Minister Klink sought advice from the Health Council of The Netherlands. But he didn't get this advice. And yet he still went ahead and made a decision. Who advised him on this?

On November 9th the Health Council of The Netherlands published a recommendation stating that it would not respond to the Minister's question as to 'whether there would be a reason for pregnant women to seek out a vaccine without an adjuvant'. The sentence in the document that follows this one seems like it could be an answer to the question, but it's not: 'Such a vaccine is not approved in Europe at this time and it is uncertain whether and in what time frame approval could take place'. With this, Klink's question still hasn't been answered yet, and what's more, this statement is also incorrect. That's because 'Such a vaccine' does exist, it's called Celvapan, it has been sanctioned at the European level and has been approved at the national level in the Medicine Evaluation Board. This was pointed out to the council by the foundation Meer Weten Over Freek in a letter dated November 18th.

Mexicaanse griep 04 [jpg]On November 24th the Dutch Health Council responded: With reference to your letter, we have discovered an irregularity, made in the course of editing the most recent recommendation by the Health Council and the Center for Infectious Disease Control to the Minister of Health, Wellbeing and Sport. We are grateful for your attentiveness to this matter'. The council admitted that Celvapan is approved, and corrected the website. Two days later Klink responded to parliamentary questions with this sentence: 'There is one vaccine approved in Europe without an adjuvant'. Nevertheless the Dutch Health Council ultimately chose not to go with Celvapan in the campaign against the Swine Flu. The reason for this, as the Council later wrote, is that it was unclear whether it would be available in time and in sufficient quantities. Yet time was short, and the Minister had to make decisions.

Additives for pregnant women as well
For his campaign, Minister Klink decided to go with vaccines containing adjuvants. In the meantime months have gone by, and more women have ended up in the pregnant-for-at-least-13-months group. They were not initially vaccinated because pregnant women up to 13 weeks didn't get the vaccine. Are they now going to get a vaccine with or without adjuvants? In a second letter to the Health Council, the foundation Meer Weten Over Freek writes it assumes that Minister Klink 'should be deemed capable of acquiring the vaccine without adjuvants for the aforementioned group of people'. Nevertheless these pregnant women will receive a vaccine containing additives.

Most important question goes unanswered
Mexicaanse griep 05 [jpg]Meanwhile the most important question hasn't been answered yet. It's Klink's question to the Dutch Health Council: Whether or not to pursue a vaccine without additives for pregnant women. Other countries 'saw good reason after all to purchase a vaccine without adjuvants', writes the foundation to the Health Council in their second letter. Just as with Minister Klink, the Health Council provided no answer to the foundation. The foundation pointed this out in a letter to Minister Klink on November 27th. It concluded that the Council's advice to him was thus incomplete. The foundation expressed its surprise at the fact that the Minister was not unsatisfied with his question not being answered by the Council. On November 30th the Health Council published a response: the Council did not wish to discuss the matter.

Who advised Klink?
In spite of the fact that the requested advice never materialized from the Dutch Health Council, Minister Klink made a decision. It was not a decision that was obvious. Klink's decision has had the effect of violating an ongoing contract with a vaccine producer, with all of the likely financial consequences. A new contract is being signed with another vaccine producer for another vaccine, this one with additives. Who advised Klink on this? More on this in the next part of this series.

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